FIRST EDITION

AIPGE 2009

Q&A

BY DR MANISH B MANDAL

ALL
INDIA
PRE-
PG
EXAM
2009
CONDUCTED BY AIIMS
Special thanks to

members who took part in collecting

questions and discuissing AIPGE2009 in rxpg forum specially Dr RAMUSSEN
Anatomy

1. Superior gluteal nerve supplies a/e

a. gluteus medius
b. gluteus maximus
c. gluteus minimus
d. tensor fascia lata

ans. b. gluteus maximus

2. Neural tube closure starts from

a. Cervical
b. Thoracic
c. Lumbar
d. Cranial

ANS. a. cervical Ref Nelson 18th ed, p2443

3. COMPOSITE MUSCLES are all except

a. flexor digitorum superficialis

b. flexor carpi ulnaris
c. pectineus
d. biceps femoris

ans: b. flexor carpi ulnaris?

4. Stenosis of subclavian artery is common in which part

a. 1st part
b. 2nd part
c. 3rd part
d. equal in all parts

Ans: a. 1st part

5. Which is not a branch of splenic art

a. pancreatica magna
b. short gastric a
c.. hilar vessels
d. rt. gastroepiploic

ans d. rt. Gastroepiploic

6. ALL are the content of deep perineal pouch except

a. deep transverse perineal muscles

b. sphincter urethrae
c. root of penis
d. dorsal nerve of penis

ans c. root of penis

7. Anatomical snuff box contain

a. radial a
b. brachial a
c. interroseus a
d. ulnar a

ANS: a. RADIAL ARTERY

8. gastrointestinal lymphoid tissue found in

a. lamina propria
b. submucosa
c. mucosa
d. serosa

ANS / Lamina propria ? Schwartz, greys page 1158 to 1159 the diagram
Ans : Lamina propria

MALT - the lymphoid nodules + mucosal lymphocytes with isolated lymphoid follicles in the
appendix and mesenteric lymph nodes. (rob)
The lyphoid tissue of the intestines lie either within the mucosa or span the mucosa and a portion of
the sub mucosa (rob)

Peyer's patches are lymphoid structures located in the mucosa of the ileum.
(http://www.siumed.edu/~dking2/erg/giguide.htm#peyer)

MALT-
� LYMPHOCYTES WHICH ARE SCATTERED DIFFUSELY THROUGHOUT THE LAMINA PROPRIA OF THE
INTESTINE. (LAMINA PROPRIA=LAYER OF CONNECTIVE TISSUE BETWEEN THE EPITHELIUM AND
THE MUSCULARIS MUCOSA)
� LARGEST SINGLE T-CELL SITE IN HUMANS. MOST OF THE T CELLS WITHIN THE LAMINA
PROPRIA ARE CD4+.

The solitary lymphatic nodules (noduli lymphatici solitarii; solitary glands) are found scattered
throughout the mucous membrane of the small intestine, but are most numerous in the lower part
of the ileum. They are situated partly in the submucous tissue, partly in the mucous membrane,
where they form slight projections of its epithelial layer. The aggregated lymphatic nodules (noduli
lymphatici aggregati; Peyer’s patches; Peyer’s glands; agminated follicles; tonsillæ intestinales).
Each patch is formed of a group of solitary lymphatic nodules covered with mucous membrane.
(Grays Anatomy )

9. chief cells are found in

a. fundus
b. neck
c. pit
d. body

Ans: a. h 17th 1855/

9. Ans: fundus

Chief cells are present in fundic glands. (Grays Anatomy ) Gastic pits are indentations of the gastric
surface epithelium. All gastric glands are situated beneath gastric pits (not in the pits)
http://www.siumed.edu/~dking2/erg/stomach.htm

10. Structure closely related to anterior commisure

a. orbit gyrus
b. uncus
c. optic chiasma
d. limen insulae

Ans: b.

11. Medulla blood supply all except

a. ant spinal
b. bulbar
c. basilar
d. post cerebellar a

Ans: c bdc 304

12. Trochlear n true a/e

a. supplies ipsilateral sup oblique

b. longest intracranial n
c. only nerve emerging dorsally from brainstem
d. enters sup. Orbital fissure outside annulus of zinn

Ans: a. h 17th 193/ b?

13. urogenital diaphragm composed of a/e

a. colles/scarpas? fascia
b. deep transverse perinii
c. perineal membrane
d. sphincter urethrae

Ans: a bdc 332

14. arteriovenous shunt

a. found in all organs
b. involved in thermoregulation
c. not under the control of ANS
d.

Ans: b

15. superior middle alveolar artery is a branch of

a. Palatal br of maxillary artery

b. nasal br of maxillary artery
c. inferior alveolar artery
d. Mandibular artery

Ans: a bdc 120

Ans: palatal br of maxillary artery? Not appropriate answer but best option.
Alveolar arteries (superior,anterior,middle-branch from infraorbital and posterior,inferior branch
from maxillary a.) http://www.pitt.edu/~anat/Head/Mouth/Mouth.htm
Infraorbital artery is a branch of pterygopalatine portion of internal maxillary artery
Branches of the Third or Pterygopalatine Portion.—
Posterior Superior Alveolar. Artery of the Pterygoid Canal.
Infraorbital. Pharyngeal.
Descending Palatine. Sphenopalatine

16. pain sensitive structure in brain is

a. middle cerebral artery

b. choroidal plexus
c. Dural sheath
d. Falx cerebri

Ans: b Ref-Hari16,85

17. Secretory pathway to parotid a/e

a. auticulotemporal nerve
b. greater petrosal nerve
c. tympanic plexus
d. otic ganglion

Ans: b. bdc 127

18. most common muscle to be congenitally absent

a. pectoralis major
b. teres minor
c. semimembranosus
d. soleus / gastronemius

Ans: a

19. popliteal artery not easy to palpate because

a. it is not superficial and not pass over prominent bony structure

b. it is not superficial
c. it does not pass over prominent bony structure
d.

Ans: a Norman L. Browse, An introduction to symptoms and signs of surgical disease, 1ed, p141

20. spongy urethra drains into which node

a. internal iliac
b. superficial inguinal
c. deep inguinal
d.

Ans: c. deep inguinal

bdc 350

21. congenital deformity of organ

a. malformation
b. deformation
c.
d.

Ans: a

22. sternberg camnal false is

a. encephalocele
b. can carry infectn to sphenoids
c. lies medial and post to foramen rotundum
d. lies lateral and ant to foramen rotundum

Ans: d
Physio

23. sleep is controlled by which centre

a. thalamus
b. hypothalamus
c. putamen
d. limbic cortex

ans b. hypothalamus h 173

24. sertoli cells function

a. testosterone secretion
b. seminal fluid secretion
c. aid in spermiogenesis
d. progesterone secretion

ans c. aid in spermiogenesis h 17th 2312

25. Intrinsic pathway is initiated by

a. Factor XII
b. Factor XI
c. Factor IX
d. Factor VII

ANS :A
Intrinsic pathway is initiated by activation of factor XII by kallikrein on negatively
charged surfaces, including glass in vitro
Factor XII, XI, and IX all belong to intrinsic pathway. Factor VII belongs to extrinsic pathway

26. intrinsic factor secreted by

a. chief cells
b. parietal cells
c. fundus
d. gastrin cells

ans parietal cells gan 491

27. when a person lies down which of the following occurs

a. immediate increased venous return

b. increased cerebral blood flow
c. increased heart rate
d.

Ans: a. gan 617 632

28. in fetus angiogenesis in eye promoted by a/e

a. VEGF
b. TGF B
c. FGF
d. IL8

Ans: B

A variety of angiogenic inhibitors have been implicated in the resolution

phase of angiogenesis, including endostatin, angiostatin, thrombospondin,
interleukin-1, interferon-beta, prostate-specific antigen, tissue inhibitors of

metalloproteinases (TIMP), angiopoietin-2, pigment epithelial derived factor(PEDF), and TGF-

beta
REF
Retinal and Choroidal
Angiogenesis
by J.S. Penn

SO TGF doesnt promote angiogenesis

29. Vasomotor centre of medulla true

a. stimulated by only baroreceptor not chemoreceptor

b. functional interaction with cardiovagal centre
c. independent from hypothalamus
d.

Ans: b? GAN 604

Ans: b. functional interaction with cardiovagal centre

Vasomotor centre is controlled by conections to hypothalamus and by both baro and chemo
receptors. (ganong)

30. after starvation which site will have reduced glucose receptor

a. brain
b. rbc
c. adipose tissue
d. liver

Ans: c. harper 27th 140

31. angiotensin functions a/e

a. vasodilatation
b. increases thirst
c. stimulates adh release
d. stimulates aldosterone release

Ans: a. gan 456

32. renal Physiology a/e

a. dct recieves hypoosmotic solution always

b. afferent artery supplies glomerulus
c. control of GFR by afferent and efferent artery
d. 5% of cardiac output received by kidney

Ans: D gan 708

Ans: d. 5% of cardiac output received by kidney

DCT receives hypoosmotic solution and kidney receives about 25 % of C.O. (Ganong)
33. the following contractions of esophagus are stationary

a. primary
b. secondary
c. tertiary
d. quarternary

Ans: c.

34. facilitated diffusion is

a. requires carrier transport

b. along concentration gradient
c. is a form of active transport
d. requires creatinine phosphate

Ans: a

35. oxygen demand of heart

a. increases proportionately with heart rate

b. depends on systolic work/ duration of systole
c. is negligible when heart is at rest
d. is in constant relation with amount of work done

Ans: b. g 575

36. cyanosis does not occur in anaemia because

a. certain min amount of reduced hb has to be present

b. in anaemia oxygen saturation increases
c.
d.

Ans: a gan 684

37. hb dissociation curve is sigmoid because

a. binding of oxygen to one molecule of hb increases the affinity of other oxygen molecules harper
27th 43

38. Action potential starts in the initial segment of axon because

a. unmyelinated
b. has least threshold
c. more ion channels
d. neurotransmitter relesed in proximal end

Ans: b.

39. Cellular regulatory mechanisms by neighbouring cells a/e

a. secretory vesicles
b. gap junctions
c. synapse
d. enzymes

Ans: C gan 491?

Ans: synapse (best option)

Gap junction transmits chemical messengers between cells (ganong)

40. Diastolic pressure head in aorta is due to

a. Aortic wall elasticity

b. muscular arterioles
c. capillaries
d.

Ans: a gan 587

41. paneth cell is rich in

a. zinc
b. lysozyme
c.
d.
Ans: B. lysozyme
Paneth cell granules contain lysozyme,an enzyme which digests the protective cell wall of certain
groups of bacteria .Lysozyme granules are secreted in response to certain stimuli.action of lysozyme
and spl phagocytic activity of paneth cell have led to conclusion that they regulate microflora of
intestines.
REF:HISTOLOGY BY ROSS

42. synovial fluid characteristics a/e

a. formed by type a cells

b. follows non Newtonian fluid kinetics
c. viscosity is variable
d.

Ans: a.
Synovial tissue is composed of vascularized connective tissue that lacks a basement membrane.
Two cells type (type A and type B) are present: type B produce
synovial fluid. Synovial fluid is made of hyaluronic acid and lubricin, proteinases and
collagenases. Synovial fluid exhibits non-Newtonian flow characteristics. The viscosity coefficient is
not a constant, the fluid is not linearly viscous, and its viscosity increases as the shear rate
decreases.
Normal synovial fluid contains 3-4 mg/ml hyaluronan (hyaluronic acid), a polymer of disaccharides
composed of D-glucuronic acid and D-N-acetylglucosamine joined by alternating beta-1,4 and beta-
1,3 glycosidic bonds [2]. Hyaluronan is synthesized by the synovial membrane and secreted into the
joint cavity to increase the viscosity and elasticity of articular cartilages and lubricate the surfaces
between synovium and cartilage.[3]
Synovial fluid also contains lubricin secreted by synovial cells. It is chiefly responsible for so-called
boundary-layer lubrication, which reduces friction between opposing surfaces of cartilage. There is
also some evidence that it helps regulate synovial cell growth.[4]
Its functions are:
reducing friction by lubricating the joint, absorbing shocks, and supplying oxygen and nutrients to
and removing carbon dioxide and metabolic wastes from the chondrocytes within articular cartilage.
It also contails phagocytic cells that remove microbes and the debris that results from normal wear
and

43. functions of T helper cells are all except

a. cytotoxic
b. help in antibody formation
c. opsonisation
d. helps memory B cells

Ans: a gan 527

44. central chemoreceptors are most sensitive to

a. low O2
b. low CO2
c. high CO2
d. H+ concentration
Ans: d gan 675?? / c?
Ans: H+ receptors. (ganong)

45. blood flow to muscles is increased during exercise

a. due to accumulation of active metabolites

b Increased BP

Ans: a gan 632

46. energy expenditure in resting state by

a. lean body mass

b. heart rate
c. adipose tissue
d.

Ans: a. HAR 486

Biochem

47. CAP in lac operon is an example of

a. positive regulator
b. negative regulator
c. constitutive expression
d. attenuation

ans: a. positive regulator

48. Following sds page elecrophoresis protein weight is found to b 100 kD. After
treatment with mercaptoethanol it shows 2 bands of 20 kd and 30 kd widely separated in
elecrophoresis pattern. True statement is

a. the protein has undergone hydrolysis of S-S linkage

b. it is a dimer of 2 subunits of 20 and 30 kd
c. it is a tetramer containing 2 20kd and 2 30kd
d. protein break up due to non covalent linkage

Ans: c. q har27th24?

49. Least polar of the following groups

a. methyl
b. carboxyl
c. amino
d. phosphate

Ans: a

50. lipoprotein lipase true a/e

a. secreted by adipocytes
b. secreted by myocytes
c. does not need CII as cofactor
d.

Ans: c does not require apo c II as cofactor har 219

51. after cutting DNA with restriction enzymes segments joined by

a. dna ligase
b. DNA polymerase
c.
d.

Ans: a har 27th 336

52. splicing is brought about by

a. sn RNA
b. m RNA
c. r rna
d.

Ans: a. snRNA har 27th 31snRNA har 27th 319

53. 2,3 disphosphoglycerate not increased in

a. chronic anaemia
b. chronic hypoxia
c. inosine
d. hypoxanthine

Ans: d

54. Acetyl Co A can't directly form

a. Glucose
b. triglyceride
c. ketone
d.

Ans: a harper27th 139

55. karyotyping used for

a. chromosomal abnormalities
b.
c.
d.

Ans:

56. Genomic imprinting

57. oxidation reduction reaction occurs with a/e

a. Hydroperoxidases
b. perosidases
c. oxidases
d. dehydrogenases

Ans a? har 96
Ans: hydroperoxidase (most probably)

58. All of the following about glutathion true except

a. Helps in conversion of haemoglobin to methaemoglobin

59. micro RNA role

a. RNA splicing
b. gene regulation
c. DNA confirmation
d.

Ans: b. harper 320

FM

60. A/E are traumatic asphyxia

a. railway accident
b. road traffic accident
c. accidental strangulation
d. stampede in crowd

ans. c. accidental strangulation reddy 163

61. stellate wound produced by

a. contact wound
b. from close range
c. 2 meters range
d. long range

ans. a. contact wound reddy 111

62. privileged communication

a b/w doctor & patient

b b/w doctor & concerned authority
c b/w doctor & guardian
d b/w doctor & court of law

ans b/w doctor & concerned authority parikh 6th 1.34

63. finger printing lost in

a HIV
b leprosy
c SCABIES
d.SCALDS

ANS b. LEPROSY

64. Caspers dictum is for

a. identification of body
b. time since death
c. type weapon used
d.

Ans: b. reddy 85

According to an old rule of thumb (Casper's dictum) one week of

putrefaction in air is equivalent to two weeks in water, which is equivalent to eight weeks buried in
soil, given the same environmental temperature.

65. which organ is most commonly involved in blast injury

a. lung
b. liver
c. intestines
d. skeletal muscle

Ans: a. parikh 4.184

66. pedestrian injured in RTA with multiple abrasions due to

a. primary impact
b. secondary impact
c. secondary injury
d. tertiary impact

Ans: c?

67. abrasions can be confused with

a. eczema
b. chemical injury
c. ant bite
d. joules burn

Ans: c ref-narayan reddy 22nd151 , parikh 4.3

68. heat rupture due to high temperature

a. regular rupture
b. irregular rupture
c. boold clotted
d. vessels rupture

Ans: b reddy 143

Micro

69. endemic relapsing fever is caused by a/e

a. B.duttonii
b. B.hermsii
c. B.recurrentis
d. B.parkeri

ans c. B. RECURRENTIS h 17th 1052

70. non invasive diarrhoea a/e

a. shigella
b. b.cereus
c. EIEC
d. y.enterocolitica

ans b.cereus h 17th 248

71. maltese cross flourescence may be seen in

a cryptococcus neoformans
b blastomycosis dermatidis
c penicillium maneffi
d candida

ans Cryptococcus
http://books.google.com/books?id=yUvhjjShhpEC&pg=PA1025&dq=maltese+cross+in+cryptococcu
s&ei=tMtwSfy3N5OMkAS88-yADg
72. enterovirus does not cause

a. aseptic meningitis
b. pleurodynia
c. herpangina
d. haemmorhagic fever

Ans: d. h 1209

73. all true except

a. hypochlorite virucidal
b. glutaraldehyde sporicidal
c. phenol require organic material
d. ethylene oxide is an intermediate grade agent

ANS:NONE OF THE ABOVE

GENERAL CHARACTERISTICS OF DISINFECTANTS

--------------------------------------------------------

ALCOHOLS (Isopropyl or Ethyl Alcohol)

Wide germicidal activity, non corrosive, but poses a fire hazard.
Limited residual activity due to evaporation.
Alcohols provide limited activity in the presence of organic matter.
Not considered effective against bacterial or fungal spores.
Excellent for disinfecting instruments or other small objects.
Too expensive for general use in the hatchery.
Must use as a 70-95% concentration for effectiveness.

HALOGENS (Iodines or hypochlorites)

Provide wide germicidal activity but are

corrosive.
Limited activity when in the presence of organic matter.
Poor residual activity, low toxicity, but may stain surfaces.
Not effective as sporocidal agents.
Effective at low concentrations for disinfecting clean, small objects.
Low cost but requires frequent applications.

QUATERNARY AMMONIUM COMPOUNDS

Limited germicidal range.
Not sporocidal, effective against vegetative bacteria, fungi and viruses.
Reduced efficiency in the presence of organic matter.
Limited effectiveness in soaps, detergents and hard water salts.
Non-irritating, non-corrosive and low toxicity.
Residual activity is limited by the amount of recontamination.
Good disinfectant for use on cleaned surfaces.
Low cost.

PHENOLICS (Single or Multiple)

Wide germicidal range, not sporocidal.
Low toxicity and low corrosiveness.

Very effective in the presence of organic

matter.
Good residual activity and deodorizer.
Low to moderate cost.

COAL TAR DISTILLATES ( Cresol and Cresylic Acid)

Wide germicidal activity, not sporocidal.
Corrosive and toxic at high concentrations.
Excellent residual activity with heavy odor.
Highly efficient in presence of organic matter.
Not well suited for use near eggs or chicks due to noxious gases.
Moderately expensive.

ALDEHYDES (Glutaraldehyde)

Wide germicidal activity, sporocidal and

fungicidal.
Slight to moderate efficiency in presence of organic matter.
Slight residual activity.
Moderately toxic.
Moderate cost.

OXIDIZING AGENTS (Hydrogen peroxide, Potassium Permanganate)

Moderate to wide germicidal activity, not sporocidal.
Rendered ineffective in the presence of organic matter.
Moderately corrosive, limited toxicity.
Poor to limited residual activity.
More valuable as a cleansing and deodorizing agent.
Moderate cost.

--------------------------------------------------------------------------------

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-----------------------------------------------------------------------------

Ethylene oxide is a versatile intermediate in

the production of various chemicals.
http://www.msstate.edu/dept/poultry/disinfec.htm

74. Pasturella multocida infection by

a. soil
b. animal bite
c.
d.
Ans: b h 801

75. parvo virus B 19 false statement is

a. can cross the placenta in only <10% cases

b. dna virus
c. causes anaemia
d.

Ans: a transplacental fetal infection incidence is <,10% h 17th 1116

The risk of transplacental infection among women who are infected during pregnancy is about 30%.
http://www.cmaj.ca/cgi/content/full/172/6/743

76. E157:O7 culture

a. sorbitol mc konky media

Ans: a. sorbitol mc konky media h 17th 942

77. True about non typhoidal salmenellosis

a. can be transmitted by eating poultry products

b. can be diagnosed by blood culture better than stool sample
c. quinolones are effective
d. severe in neonates

Ans: ?
Ans: a,c,d are true. May be the Q should be A/E. Then ans of exclusion is b. stool culture is better
than blood culture. (Harrison

78. Lambda phage a/e

a. phage undergoes lytic cycle as it fuses with host

b. lysogenic
c. fuses with the host chromosome and remains dormant
d.

Ans:

Lambda is a temperate phage that can grow in either a lytic or lysogenic life cycle. This is
manifested morphologically by production of turbid plaques, in which surviving infected bacteria are
present.
• Phage lambda can do 2 different things when it enters the cell:
– lytic cycle: it can start reproducing itself immediately, which produces about 200
new phage in 15 minutes and kills the cell
– lysogenic cycle: the lambda DNA can integrate into the host chromosome and
remain dormant for many generations. When given the proper signal, the
integrated DNA (prophage) leaves the chromosome and enters the lytic cycle.

79. all are true except

a. streptodornase breaks dna

b. streptokinase is produced by A,C,G
c. streptolysin o acts in reduced state only
d. erythrogenic toxin is plasmid mediated

Ans: d. anant 191

SPM

80. The vaccine having highest efficacy

a. measles
b. tetanus
c. pertusis
d. BCG

ANS-A

Efficacy of routinely used vaccines*

Diphtheria: 87%-96%

Tetanus: >90%
Pertussis: 35%-96%
Recent studies have shown that pertussis vaccines currently in use in the United Kingdom have
efficacies of over 90%
Haemophilus influenzae type b (conjugate vaccines): 94%-100%
The polyribosylribitol phosphate-diphtheria toxoid conjugate vaccine (not used in the United
Kingdom or the United States) may have a lower efficacy in some populations
Oral polio: 90%-100%
Oral polio vaccine seems to be less immunogenic in developing countries

Measles: 90%-95%
Mumps: 90%-98%
The Rubini strain of vaccine virus has a lower efficacyin fact, a general study showed it to have no
protective efficacy14
Rubella: >95%
BCG (Bacille Calmette-Guérin): 0%-80%
In British schoolchildren efficacy has been found to be almost 80%, whereas a study in
schoolchildren in Georgia in the United States showed no protective effect
*A wide range of efficacies has been reported, depending on vaccine, conditions of use, and target
group (for further data on efficacy see Plotkin and Orenstein)1

http://www.whale.to/vaccines/efficacy.html

SO WE CAN CONCLUDE THAT EFFICACY OF MEASLES>TETANUS

81. Chemprophylaxis not used in

a. cholera
b. plague
c. meningococal meningitis
d. typhoid

Ans: d. typhoid park 19th 106

82. Which is the latest guideline used in calculating disability

a. absentism from job

b. economic productivity
c. fever
d. loss of sleep

ans a. absentism from job

83. incidence can be calculated by

a. case control study

b. cross section study
c. prospective study
d. retrospective study

ans c. prospective study park 19th 71

84. indian reference man has weight

a. 70kg
b. 50kg
c. 60kg
d. 55kg

ans 60kg park 500

85. When the variables follow standard distribution

a. mean = median
b. median = variance
c. mean = 2 median
d. standard deviation = 2 variance

Ans: a. mean = median mahajan 6th ed 81

86. Mode of transmission of Q fever

a. Ticks
b. Mites
c. Aerosols
d. Mosquito

Ans: c. aerosols park 19th 252

87. Vitamin A prophylaxis is the example of

a. primordial prevention
b. health promotion
c. specific protection
d. disability limitation

ans c. specific protection park 19th 39

88. finnish type nephrotic syndrome is due to

a. nephrin gene
b. alpha actinin
c. TRP6
d. PODOCIN

ANS: a. nephrin gene

89. imci includes a/e

a. malaria
b. resp infections
c. diarrhoea
d. TB

ans: d. TB

90. hiv maximum transmission

a. homosexual
b. heterosexual
c. blood transfusion
d. needle prick

ANS: c. blood transfusion park 289

91. all are analytical studies except

a. field trials
b case control
c. cohort
d ecological

ANS: a. FIELD TRIAL park 19th 58

92. baby friendly hospital all are true except

a. breast feeding on demand

b. initiates breast feeding within 4 hours of normal delivary
c. allow mothers & infants to remain together 24 hours day
d. train all health care staff

ans: b. park 444

93. intended outcome of a program not measurable in operational term and need not be
achived at the end

a. TARGET
b. MISSION
c. GOAL
d. objective

Ans: c?? d. park 721

94. intended outcome of a program not necessary measurable in operational term need
not be achived at the end

a. TARGET
b. MISSION
c. GOAL
d. objective

Ans. c.??

95. On a given day a hospital had 50 admissions. 20 girls and out of which 10 needed
surgery and out of 30 boys 20 needed surgery. so what is the probability of picking up a
person requiring surgery.

a. 3/5
b. 2/6
c. 6/5
d. 1/2

Ans: a.

96. latest WHO scale of disability

a. IDEAS
b. ICDH-…
c. WHO-DAS
d.
Ans: a.

97. DMS IV include monetary benefit for

a. schizophrenia
b. bipolar affective disorder
c. mental retardation
d. dementia

Ans: c.

[snip]. continous data is represented by

a. histogram
b. simple bar diagram
c. linear plot
d. multiple bar diagram

Ans: a. mahajan 20

99. all true about spread of infection except

a. leptospirosis rat urine

b. tetanus dust droplets
c. listeria refrigerated food
d. legionella aerosol

Ans: b h 17th 898

100. water sample estimation a/e

a. clostridium perfringes spores denote recent contamination

b. multiple tubes used to collect bacterial count
c. …. is added to water to remove residual chlorine
d.

Ans: a park 580

101. nutritional survey a/e

a. 1 to 4 year mortality
b. babies < 2.5 kg
c. mother hb < 11.5
d.

Ans: c park 519

102. crude birth rate a/e

a. it is ratio
b. good fertility indicator
c. still born excluded
d.

Ans: a

103. aedes mosquito a/e

a. repeated biters
b. eggs cannot survive more than one week without water
c. transmit dengue
d. incubation period in mosquito is 7-8 days
Ans: B
Ans: b. eggs cannot survive more than one week without water.
Eggs can actually survive for months with out water. Park does not mention anything about
repeated biting or about eggs survival.

• Aedes aegypti is the vector of dengue / dengue haemorrhagic fever.

• It is a small, black mosquito with white stripes and is approximately 5 mm in size.
• It takes about 7 to 8 days to develop the virus in its body and transmit the
disease.Feeding Habit
• Day biter
• Mainly feeds on human beings in domestic and peridomestic situations
• Bites repeatedly
Resting Habit
• Rests in the domestic and peridomestic situations
• Rests in the dark corners of the houses, on hanging objects like clothes, umbrella, etc. or under
the furniture
Breeding Habits
• Aedes aegypti mosquito breeds in any type of man made containers or storage
containers having even a small quantity of water
• Eggs of Aedes aegypti can live without water for more then one year

104. dengue hmgic fever caused by

a. type 1 serotype
b. reinfection with the same serotype
c. reinfection with diff serotype
d.

Ans: c. h 1239

105. simple random sampling

a. everyone has equal chance of being drawn

b. sample size eual to that of cluster sampling
c.
d.

Ans: a. park 703

106. preventive strategy in spread of aids a/e

a. behaviour education
b. treatment of STD
c. antiretroviral treatment
d. condoms

Ans: c park 17th 357

107. the following vaccine when contaminated causes toxic shock syndrome

a. measles vaccine
b. BCG
c. DPT
d. oral polio

Ans: a. park 129

108. late expanding phase of population

a. birth rate stationary death rate falling

c. birth rate lower than death rate
c. falling death rates with low birth rate
d. birth rate falls and death rates declines still further

Ans: d. park 19th 379

109. true statement of RDA

a. average daily requirement of all nutrients

b. average daily requirement of all nutrients except energy +2SD
c. indicates adequacy of intake
d. it is calculated to meet the need of individual
ANS-B

110. icd 10 includes all except

a. lack of exercise
b. alcoholism
c. poisoning
d. unhealthy food.

Ans: c. poisoning is icd

All options are included in ICD 10. Among them all are in chapter XXI of ICD 10 except poisoning
which is in chapter XIX of ICD 10, which may be the answer. (park)

111. Benign HTN

a. hyaline aterioscelerosis
b. cystic medial necrosis
c. fibrinoid necrosis
d.

Ans: a.

112. Chronic diseases depend on a/e

a. dose response relationship

b. temporal relationship
c. biological plausability
d. consistency

Ans a. park 19th 84

*(302). STEPS

a. assessing risk factors of incidence of non communicable diseases

b. assessing incidence of non communicable diseases
c. assessing treatment compliance of non communicable diseases patients
d. assessing rate of mortality of non communicable diseases

Ans: A

assessing risk factors of incidence of non communicable diseases

A tool for surveillance of risk factors, WHO STEPS, has been developed to help low and middle
income countries get started. http://www.who.int/mediacentre/factsheets/fs273/en/

113. Person with sub clinical folate def., following drugs will ppt folate def except

a. alcohol
b. chloroquine
c. sulfasalazine
d. phenytoin
ans. b. chloroquine h 17th 649

114. Drug which can be used in any degree of renal failure:

a. Cefepime
b. Cefoperazone
c. Cephaloridine
d. Cefuroxime

Ans: b.

115. Ifosamide belongs to which class

a. Alkylating agents
b. Antimetabolite
c. Folate antagonists
d. Plant alkaloids

ans: a. alkylating agent katzung 882

116. Rx of osteoporosis drug that both decreases bone resorption and increases bone
deposition.

a. ibandronate
b. teriparatide
c. strontium ranelate
d. calcitonin

ans stronsium ranelate ref-Harisson 17th edn,pg no 2407

117. H2 hand foot syndrome caused by

a. cisplatine
b. mitomycine
c. cytarabine
d. capecitabine

ans capecitabine

118. which of the following is cell cycle specific

a. ifosamide
b. bleomycin
c. cisplatin
d. vincristine

Ans: A. katzung 881?

119. tacrolimus is

a. hepatoxic
b. nephrotoxic
c. ototoxic
d.?

Ans: b.

120. Most effective drug in complicated falciparum malaria

a. cloroquine
b. quinine
c. artisunate
d.artimether

Ans: c h 1289

121. Appetite stimulant a/e

a. melanocyte stimulating hormone

b. melanocyte corticotropic releasing hormone
c. neuropeptide Y
d.

Ans: msh h 17th 464

122. all of the following drugs are used in narrow angle glaucoma except

a. duloxetine
b. citalopram
c. fluphenazine
d. clozapine

ans-D
123. valproate causes a/e

a. weight gain
b. alopecia
c. liver damage
d. osteomalacia

Ans: d. kat 387

124. all are the uses of lithium except

a. major depression
b. generalized anxiety disorder
c. vascular headache
d. neutropenia

Ans: a

125. amifostine is protective in a/e

a. salivary gland
b. skin
c. GIT/ kidney
d. CNS

Ans: d

126. the nephrotoxicity of cisplatin is increased by a/e

a. rifampicin
b. vancomycin
c. gentamycin
d.

Ans: a.

127. Which of these is an FDA approved indication for use of modafinil as an adjunct

a. Major depression and associated lethargy

b. Narcolepsy
c. Obstructive sleep apnea
d. Shift work disorder

ANS-C

modafinil is used as adjunctive therapy for

obstructive sleep apnea/hypopnea syndrome
(OSAHS)
128. bleomycin toxicity affects which type of cells

a. type 1 pneumocyte
b. type 2 pneumocyte
c. endothelial cell.
d. alveolar macrophage

Ans: A&C

Bleomycin toxicity include endothelial and type I pnumocyte necrosis, with type II pneumocyte
hyperplasia and hyaline membranes.

129. true about nitroglycerine/ nitric oxide?

a. hypotension and bradycardia
b. vasodilation
c. methaemoglobinemia
d.

Ans: A,B,C

NO leads to vasodilation.
ADVERSE REACTIONS SIGNIFICANT
>10%:
Cardiovascular: Hypotension (13%)

Doses above 20 ppm should not be used because of the

increased risk of methemoglobinemia

Nitric oxide-cGMP pathway facilitates acetylcholine release and bradycardia during

vagal nerve stimulation in the guinea-pig in vitro
130. topical mitomycin c is used in

a. sturge weber
b. laryngeal stenosis
c. endoscopic angiofibroma
d. skull osteomyelitis

Ans: a/b

Path

131. Psammoma bodies seen in a/e

a. Follicular ca thyroid
b. RCC
c. Serous cystadenoma
d. Meningioma

Ans. a. Follicular ca thyroid

132. organelle that plays a pivotal role in apoptosis

a. cytoplasm
b. golgi complex
c. mitochondria
d. nucleus

ans: c. mitochondria rob 29

133. colon carcinoma a/e

a. mismatch repair genes

b. k ras
c. b cantenin
d. apc

Ans: beta catenin h 17th 574

134. coagulative necrosis is seen in

a. gangrene
b. tuberculosis
c. sarcoidosis
d. some fungal infection

Ans: A
gangrene – better answer (after searching varios web sites)

135. Seen in acute inflammation classically

a. vasodilatation with increased vascular permeability

b. vasoconstriction
c. leucocyte margination
d.

Ans: a r 50

136. 45 year old male had a chest pain. he died after 4 days. on postmortem intramural
coagulation was found. Microscopically seen is

a. neutrophils
b. granulation tissue formation
c. collagen and fibroblasts
d. scar

Ans: b. r 579?

137. Basic defect in Hb S is

a. altered function
b. altered solubility
c. altered stability
d. altered O2 binding capacity
Ans: b harper 27th 47? a. h 594 16th edn 91-1 table

138. intestinal absorption test

a. xylulose absorption
b. fat in stools
c.
d.

Ans: b. h 1877

139. fatty content in breast is found in a/e

a. traumatic fat necrosis

b. galactocele
c. hamartoma/ adenosis?
d. seborrheic keratitis

Ans: d?

140. ageing true

a. free radical injury

b. accumulation of harmful mutations in somatic cells
c.
d.

Ans: a. robbins 7th 42

141. most bactericidal of these:

a. cationic basic protein

b. lactoferrin
c. lysozyme
d. reactive o2 species

Ans: d. r 61,75

142. clot stabilisation factor-13

143. hypersensitive pneumonitis is type of

a. type 3 hypersensitivity
b. type 4 hypersensitivity

ANS-A

The small size (1 µm) of the spores allows them to reach the smallest airways and alveoli to

“hypersensitivity
provoke a reaction that has been termed a

pneumonitis”; this is considered to be

predominantly a Type III hypersensitivity
reaction, although a Type IV hypersensitivity
component is suspected (see
immunopathologic diseases, Immunopathologic Diseases:
Introduction et seq).
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/121223.htm

144. Hirsutism is caused by A/E

a. cushing syndrome
b. acromegaly
c. hyperthyroidism
d. hyperprolactinaemia

Ans c. hyperthyroidism h 17th 301

according to harrison hyperthyroidsm causes hirsuitism.answer should b hyperprolactinemia
hyperthyroidism. See table 50-1 harrison 17th ed.

145. calcification of post spinal ligament a/e

a. begins from thoracic level

posterior longitudnal ligament
b. some CT finding was given
c. t1wi and t2w2 both are hypointense
d. begins from lumbar level

Ans: ?

146. WHICH IS EXPRESSED BY GIST

a. CD 117
b. CD 34
c. CD 45
d. S100

ANS: a. CD 117 r 827

there is difference of percentage CD 117 PRESENT IN 95 % & CD 34 present in 60-80 %.

147. which of the following pair is incorrect

a. selenium deficiency causes cardiomyopathy

b. zinc deficiency causes pulmonary fibrosis
c. increased calcium causes iron deficiency
d. vitamin A deficiency occures after 6 months to 1 year of low vitamin a diet

ans: b. Harrison 17th table 71-2??

148. In obstructive azoopermia

a. FSH & LH both increase

b. FSH & LH both normal
c. FSH decrease but LH increase
d. FSH & LH both decrease

ans b. FSH & LH both normal h 2314

149. which nerve escapes entrapment synd

a. femoral
b. radial / common digital?
c. tibial
d. lat cut n of thigh

ans femoral?? Tibial?

150. hiv enters via

a. cd4
b. cd5
c. cd6
d. cd 56

ANS a. CD4 h 17th 1139

151. C wave in jvp is due to

a. atrial contraction
b. tricuspid valve bulging into right atrium
c. right atrial filling
d. rapid ventricular filling

ans: b. tricuspid valve bulging into right atrium

152. 4year old boy present with recurrent chest infections. Sweat chloride test was done
showed values of 36 & 42. What is the next best investigation to confirm the diagnosis

a. 72 hour fecal estimation

b. CT chest
c. trans epithilial nasal potential difference
d. DNA analysis of delta f 508 mutation

ans: c. trans epithelial nasal potential difference

153. tuberous sclerosis triad HAVE a/e

a.facial angiomatosis
b mental retardation
c seizures
d rhabdomyoma

ans: d rhabdomyoma h 2607

154. a 29 year old male was taking oral hypoglycemic drugs and he never had ketonuria
in his life . his grandfather had diabetes and his father who is only son of his grandfather
did not have the disease. the type of DM the person can never have is

a. pancreatic DM
b. MODY
c. type I
d. type II

ANS TYPE I DM h 2279?? mody??

155. 24 year old male presenting with abdominal pain, rashes, palpable purpura, arthritis
/ foamy histiocytes and intense neutrophilic infilterates in a patient presenting with fever
and lymphadenopathy ....diagnosis is

a. HSP
b. sweet synd
c. meningococcimea / ENL
d. hemochromatosis / rauf daufman disease

ANS: Sweet synd??

156. pulsating large liver seen in

a TR
b AR
c MR
d MS

ANS TR h 1479

157. Systolic thrill is heard in Ist and 2nd Intercostal space in all except

a. Pink tetralogy of fallot

b. Ebstein's anomaly
c. valvular Pulmonary stenosis / tricuspid atresia?
d. sub pulmonic VSD

Answer: A) Pink tetralogy of fallot?? Ebsteins?

the answer is ebstein's anomaly

ref:ghai-in fallot's syst. thrill SEEN IN 30% CASES..
in ebsteins-RARE...AND AGAIN I CHECKED WITH A CARDIOLOGIST...HE SAYS IT COMES IN ALL THE
GIVEN OPTIONS BUT..THE RAREST OF THEM ALL IS EBSTEIN'S(REASON-ITS ASSOC. WITH ASD
RATHER THAN A VSD MOST OF THE TIMES) sgdd

158. Cardiac manifestations of HIV A/E

a. Cardiomyopathy
b. aortic aneurysm
c. recurrent artrial emboli
d. Cardiac tamponade

Ans: b Ref-Hari17th,1174

159. spastic paraplegia is caused by a/e

a. vitb12 deficiency
b. cervical spondylosis
c. MOTOR NEUROPATHY
d. LEAD POISONING

ANS:LEAD POISONING?? CERVICAL SPONDYLOSIS? IT IS A REPEAT ALL INDIA QUESTION

vannu2006

160. pseudoclaudication seen due to COMPRESSSION OF

a. femoral A
b. poplitial A
c. cauda equina
d radial A

ans: c. cauda equina

161. intermittent claudication

a. pain in the limb

b. pain on the start of walking
c. pain at the end of walking
d. pain on doing exercise

Ans: d. h 1168

162. 20yrs. old male with Hb-10 MCV 70 serum iron 65 serum ferritin 100 what is the
diagnosis

a. iron deficiency
b. thallasemia trait
c. folate deficiency
d. b12 deficiency

Ans: b.

163. A girl aged 8yrs has been admitted for dialysis. She has serum K of 7.5meq/l. Which
is the fastest way to reduce the hyperkalemia

a. Kayexelate enema
b. Infusion of insulin+glucose
c. Iv calcium gluconate
d. Iv NaHCO3

Ans: b.

164. Gut bacteria cant ferment

a. cellulose
b. pectin
c. lignin
d. starch

Ans: a HAR 116 /d?? c. sabiston

little starch is reaching the colon.. The bateria are not known to possess any amylase... They can
act on cellulose to convert it to butyric acid.. Its only partial but it occurs..dreamanaesthesia

165. Foreign body sensation in the eye with right knee swelling in a 29 yrs old man

a. tb
b. sarcoidosis
c. reiters disease
d.

Ans: c h 17th 2113

166. Immediately after eating dyspneoa, cyanosis and not being able to breath after few
hours

a. angioneurotic edema
b. food stuck in larynx
c. esophagus rupture
d. MI

Ans: a h 2066

167. Multiple punched out lesions in skull in a 65 yrs old man, which is best or diagnosis

a. serum electrophoresis
b. calcium
c. alp
d. bone scan

Ans: a. h 704

168. Pauci immune glomerulonephritis in

a. microangiopathic polyangitis
b. alport
c. sle
d. HSP/ goodpasteurs?
Ans: a rob 977 /d?

169. Coombs positive anaemia in

a. sle
b. ttp
c.
d.

Ans: a. h 659

170. scarring alopecia caused by

a. lichen planus
b. androgenic alopecia
c. alopecia areata
d. tinea capitis

ans a. lichen planus h 322

171. all are direct cutaneous disease except

a. psoriasis
b. reiter’s disease
c. lichen planus
d.

Ans: b h 2066

172. involvement of sweat gland, dermal appendages and hair follicles with epitheloid
granuloma

a. lichen scrofulosum
b. military tb
c. papulonecrotic tuberculide
d.

Ans: a?

173. hypercoagulability a/e

a. burns
b. hemmorhage
c. infections
d. surgery of 1 hr duration

PREFERRED RESPONSE-D (NOT A,SORRY FOR TYPING MISTAKE IN PREV

POST)

Dont exactly rem the question but as per the options provided by
ramussen

all four choices cause hypercoagulability ,but incidence is minimum after

surgery of 1 hr duration in pt with no additional risk factor apart from age >40 yr

A VERY CONTROVERSIAL QUESTION

174. causes of DVT a/e

a. OCP
b. polycythaemia
c. IBD
d. PNH

ANS-D

PNH is also associated with an approximately 40 percent incidence of venous thrombosis

in the intraabdominal venous network (mesenteric, hepatic, portal, splenic, and renal
veins) and cerebral vessels, as opposed to deep vein thrombosis or pulmonary embolism
175. features of pnh a/e

a. DVT
b. massive splenomegaly
c. Budd-Chiari syndrome
d.

Ans : b massive splenomegally h 17th 661

176. positive urinary anion gap a/e

a. alcoholoic ketoacidosis
b. diabetic ketoacidosis
c. glue poisoning
d. diarrhea

Ans: d h 17th 290

177. Which does not occur in RCC

a. polycythemia
b. cushings
c. malignant HT
d.

Ans: c h 17th 592, rob 4 pg 1018

178. incontinenti pigmenti

a. 100% ocular problems

b. x linked dominant
c. skin lesions present
d. associated with eye problems

Ans: D

179. neurofibromatosis a/e

a. autosomal recessive
b. neurobifromas
c. cataract
d. scoliosis

Ans: a.

180. von hippel landau syndrome consists of a/e

a. gastric cancer
b. renal cell carcinoma
c. phaechromocytoma
d. cerebral and retinal haemangiomas

Ans: a. r 1414

181. necrotising fasciitis a/e

a. most commonly due to group A beta haemolytic/ group b? streptococcus

b. debridement is mandatory
c. involves trunk and lower limbs
d.

Ans: a h 17th 801

182. hepatitis C true statement is

a. important cause for liver transplantation

b. does not cause liver cancer
c. dna virus
d. doesn't cause coinfection with hbv

Ans: a. h 1990

183. restless leg syndrome seen in

a. chronic renal disease

b. hyperkalemia
c. hypocalcemia
d.

Ans: a. h 174

184. carpal tunnel syndrome caused by a/e

a. hyperthyroidism
b. acromegaly
c. addisons
d. cushing

Ans: addisons h 2154

185. a lady with temporal field defects, galactorrhoea, most probable cause

a. pituitary macroadenoma
b. craniopharyngioma
c.
d.

Ans: a h 2202

186. juvenile arthritis all are present except

a. rheumatoid nodules
b. uveitis
c. fever
d.

Ans: a

187. hepatomegaly is caused by a/e

a. gauchers ds
b. niemann pick
c. hepatic porphyria
d. hurlers ds

Ans: c. harrison 2438

188. recurrent laryngeal papillomatosis false

a. most commonly by HPV 6 and HPV 11

b. HPV 6 is more virulent
c. caused by exposure during delivery in mothers birth canal
d. HPV is a DNA virus

Ans: b? STELL AND MARAN HEAD AND NECK SURGERY 4TH 235

189. all are true about eaton lambert syndrome except

a. positive tensilon test

b. spares bulbar and ocular muscles
c. muscle contraction improves with repeated stimuli
d. mainly involve proximal musles
Ans: B

Definition Return to top

Lambert-Eaton syndrome is characterized by muscle weakness that improves with continued

contraction of the muscle.

Causes Return to top

Lambert-Eaton syndrome (myasthenic syndrome) is a disorder with symptoms very similar to those
of myasthenia gravis. There is muscle weakness associated with disturbed communication between
nerves and muscles.

In myasthenia gravis, the neurotransmitter acetylcholine (the chemical that transmits impulses
between nerves and muscles) is blocked by antibodies to its receptor.

In Lambert-Eaton syndrome, however, the signal distortion is caused by an insufficient release of

neurotransmitter by the nerve cell. As muscle contraction is continued, the amount of
neurotransmitter may build up in sufficient quantities and result in increased strength.

The disorder may be associated with small-cell carcinoma of the lung and other malignancies as a
paraneoplastic syndrome or with autoimmune disorders.

Symptoms Return to top

Weakness/paralysis that varies in severity

Drooping head
Difficulty climbing stairs
Difficulty lifting objects
Need to use hands to arise from sitting or lying positions
Difficulty talking
Difficulty chewing
Swallowing difficulty, gagging, or choking
Vision changes
Blurry vision
Difficulty maintaining steady gaze
Additional symptoms that may be associated with this disease:

Blood pressure abnormalities

Dizziness upon standing
Dry mouth
Exams and Tests Return to top

An examination shows weakness or paralysis that improves with activity. Reflexes may be
decreased. There may be muscle atrophy (loss of muscle tissue).

A Tensilon test can be positive. A baseline

muscle-strength evaluation is performed. After
Tensilon (edrophonium) or other short-acting neurotransmitter is given, there may be a noticeable
improvement of function.

EMG and nerve conduction velocity tests may confirm the diagnosis, with improved function as
contraction is prolonged or with repetitive stimulation.------------

http://www.nlm.nih.gov/medlineplus/ency/article/000710.htm

---------------------------------------------------------

Patients with LEMS can have prominent ocular

or oropharyngeal manifestations, which may
be the chief or initial complaint in some.
190. cystic fibrosis all are true except

a. defect in calcium channel

b.
c.
d.

Ans: a

191. Rheumatoid factor will give false positive tests with

a. coombs test
b. hbsag
c.
d.

Ans: a

192. chronic limb ischaemia true is

a. rest pain
b. pain on exercise
c.
d.

Ans: a csdt 12th 798

193. SIRS includes all except

a. thrombocytopenia
b. leucocytosis
c. oral temperature > 38 degree C

Ans: thrombocytopenia h 17th 1696

194. all are true regarding Hb S except

a. glutamine replaced by valine
b. heterozygotes are protected against malaria
c. increase in sticky patch due to substitution of nonpolar residue by polar residue
d. single base substitution lead to RFLP

Ans: c harper 27 47

195. Chlamydia infection, true statement a/e

a. can be cultured
b. vaginal swab used for diagnosis
c. symptomatic
d. women taking ocp are carriers

Ans: c?

196. Angioneurotic edema false

a. C 1 esterase deficiency
b. Angiotensin converting enzyme deficiency
c. pittin in nature
d.

Ans: c. pittin in nature h 17th 2066??

197. hyperaldosteronism a/e

a. metabolic acidosis
b. hypokalemia
c. hypernatremia
d. hypertension

Ans: a. h 17th 288

198. Joint aspiration in acute gout shows

a. monosodium urate crystals

Ans: a

199. won't be present in right heart failure

a. increased PCWP
b. pulsatile liver
c. increased JVP
d.

Ans: a. r 563

200. Best marker for stratification of cardiovascular risk

a. Lp a
b. homocysteine
c. chlamydial antibody
d. CRP

ANS-D

There is significant association between elevated serum or

plasma concentrations of CRP and the prevalence of
underlying atherosclerosis, the risk of recurrent
cardiovascular events among patients with established
disease, and the incidence of first cardiovascular events
among individuals at risk for atherosclerosis
201. temporal arteritis true a/e

a. can cause sudden b/l blindness

b. in elderly women
c. females more than males
d. worsens on warmth exposure

Ans: d. h 96

202. False about mesial temporal lobe sclerosis

a. obliteration of fornices
b. hippocampal sclerosis
c.poor differentiation of grey & white matter
d. temporal lobe sclerosis

ANS-A?

Associated findings with hippocampal sclerosis.

Coronal T2-weighted MR image in a patient
with left hippocampal sclerosis shows
asymmetric thinning and atrophy of the left
fornix compared with the normal right fornix
-------------------------

The head, body and

tail of the hippocampus were
involved, with associated poor greywhite
matter differentiation.
SA JOURNAL OF RADIOLOGY • July 2005
203. hereditary hemochromatosis true except

a. females more than males

b. genetically heterogeneous
c. complete penetrance
d. phlebotomy is not done
Ans: D

204. Not seen in Idiopathic pul haemosiderosis

a. eosinopenia
b. iron deficiency anaemia
c.
d.

Ans: a eosinopenia ?

Iron deficiency anemia, which can range from

mild to severe, is generally the only cause of
laboratory abnormalities in patients with IPH

205. when patient with hyperglycemia is given insulin result is

a. hypokalemia
b. hyperkalemia
c. hyponatremia
d. hypernatremia

Ans: b.? d H 2285

206. International Prognostic Index of lymphoma a/e

a. haemoglobin
b. serum pr
c. LDH
d.

Ans: d? h 17th 692

207. Xanthogranulomatous pyelonephritis false

a. causative organism is tb

Ans: causative organism is tb r 1001

208. leptospirosis all except

a. transmitted by rodent urine

b. penicillin iv is tt in severe cases
c. 5 to 15 percent mortality in severe cases
d. antibody can b detected in a week

Ans d har 1050

209. positive hepatojugular reflux is found in conditions except

a. tricuspid regurgitation
b. right heart failure
c. decreased afterload
d.
Ans : decreased afterload

210. hypercalcemia a/e

a. celiac disease
b. hyperparathyroidism
c. milk alkali
d. sarcoidosis

Ans: a h 2380,1880

211. in a patient of acute myeloblastic leukemia with high leucocytosis what shouldn't be
done

a. hydration
b. immediately start chemotherapy
c. allopurinol
d. alkalinsation of urine

Ans: b. h 680
[/i]

Surgery

212. Smoking is not associated with which carcinoma

a. Ca esophagus
b. ca larynx
c. ca nasopharynx
d. ca urinary bladder

Ans: c. Ca nasopharynx h 487

213. Concomitant chemoradiotherapy given in A/E:

a. T2N0M0 glottic ca
b. stage 3b ca cervix
c. ca anal canal
d. nasopharyngeal ca

Ans. a. T2N0M0 glottic ca / b?

214. Focal diffuse gall bladder wall thickening with comet tail reverberation artifacts on
USG is in

a. xanthogranulomatosis cholecystitis
b. adenomatous polyp
c. adenomyomatosis
d. gall bladder carcinoma

ans c. adenomyomatosis

215. in proteus infection

a. Triple phosphate
b. oxalate
c. uric acid
d. cystein

ans: a. phosphate h 17th 1819

216. lumber sympathectomy is of value in the management of all except

a. arteriovenous fistula
b. distal ischemia
c. intermittent claudication
d. anhidrosis

ans: d. anhidrosis

217. SEPS done for

a. veins
b. artery
c. AV fistula
d. Lymphatics

Ans: a.

218. Parastomal hernia MCC

a. loop colostomy
b. end colostomy
c. loop ileostomy
d. end ileostomy

Ans: b.

219. thyroid papillary ca 2cm. management

a. near total thyroidectomy with rnd

b. hemithyroidectomy
c. total thyroidectomy with rnd
d.

Ans: c. csdt 285

220. difference between follicular adenoma and carcinoma

a. hurthle cell
b. increased mitosis
c. vascular invasion
d.

Ans : c h 17th 2245

221. trauma patient with gcs score 15, bp 100/80 next step

a. iv fluid with blood for cross matching

b. immediate blood transfusion
c. take him to OT immediately
d.

Ans: a. csdt 214

222. In pancreatic transplant patient with bladder catheter which investigation to

evaluate function

a. urine amylase
b. blood amylase
c. blood glucose
d.

Ans: a. gray 1795

223. Abdominal Aortic Aneurysm ruptures

a. anteriorly
b. posteriorly
c. laterally
d. intra peritoneally

Ans: c? b. ref: bailey

224. Regarding pancreatic cancer true a/e

a. More than 75% have p53 mutations

b. More common in people with familial pancreatitis
c. 3-6 m survival in stage 3
d. 15-20% survival on 5 yrs

Ans: A
Mutations in the p53 gene, located on chromosome 17p, are found in 50 to 60 percent of pancreatic
cancers

225. gold standard test to diagnose insulinoma

a. c peptide levels
b. 72 hrs fasting glucose
c. glucose value < 32mg%
d.

Ans b.

226. zenkers diverticulum true statement is

a. it is outpouching of ant pharyngeal wall above the cricopharyngeus muscle

b. barium swallow lateral view for diagnosis
c. it is a true diverticulum
d. it is congenital

Ans b.

227. triple assessment of cancer breast includes

a. clinical examination, cytology/biopsy, mammography/USG

b. FNAC, mammography, history

Ans: a.

228. small cell lung cancer true statement

a. it is chemosensitive
b. does not involve the bone marrow
c. peripheral
d. arises from alveoli

Ans a. h 17th 561

229. risk factor 4 GB Ca a/e

a. >5mm polyp
b. polyp with stones
c. increase in size of polyp
d. elderly
Ans: a.

230. best graft for surgery below inguinal ligament is

a. reverse saphenous vein graft

b. Dacron
c. Ptfe
d.

Ans: a.

231. Hashimoto's thyroiditis true a/e

a. follicular destruction
b. increase in lymphocytes
c. orphan annie eye nucleus
d. oncocytic cells

Ans: c. h 2230

232. which prevents colon cancer

a. high fibre diet

b. selenium
c. antioxidants
d. fatty food

Ans: a.

233. mc cause of superficial thrombophlebitis

a. trauma
b. infection
c. i.v. line
d.

Ans: c csdt 12th 858

234. thoracic outlet syndrome diagnosed by

a. clinical examination
b. ct scan
c. X ray
d. digital subraction angiography

Ans: d DSA shows post stenotic dilatation which is definitive csdt12th 822
a. 1489 h 16

235. ICG angiography is primarily indicated in

a. minimal classical CNV

b. Occult CNV
c. angioid streaks with CNV
d. polypoidal choroidal vasculopathy

Ans: b. Occult CNV

236. malignancy in thyroid is indicated by all except

a. collumnar cells in follicles/ irregular margins?

b. microcalcification
c. hypoechoiec
d. hyperechoic?

Ans: d?

237. Moderate grade risk factor of Breast carcinoma

a. atypical hyperplasia
b. adenosis
c. squamous metaplasia
d. ……. metaplasia

Ans: a. r 1130

238. Colon carcinoma single most imp prognostic factor

a. lymph node status

b. site of lesion
c. extent of lesion
d. type of lesion

Ans: lymph node status h 17th 575

orthopaedics

239. Myodesis is contraindicated in

a. children
b. tumor
c. ischemia
d. paralysis

Ans: c. ischemia

240. osteosarcoma, used in T-10 protocol is

a. high dose methotrexate
b. cisplatin
c. vincristine
d. Etoposide

ANS :A

T10 protocol using methotrexate, doxorubicin, cyclophosphamide, dactinomycin, and

bleomycin
REF: Chemotherapy Source Book, The , 4th Edition by Perry, Michael C
241. which joint have least chances of recurrent dislocation

a. shoulder
b. hip
c. patella
d. ankle

ans: ankle

242. whats motorcyclist's fracture

a. ring fracture
b. skull divided into anterior & posterior half
c. suture separation
d. comminuted fracture
ans: b. reddy synopsis 19th ed 129

243. Rate of mineralisation of newly formed osteoid

a. vonkossa staining for calcium

b. alzarin red
c. Labelled tetracycline
d. Flourescence

Ans: c.

244. Milkman #

a. pseudo#
b. fracture of metatarsals
c. fracture of distal end of radius
d.
Ans: a.

245. Chronic low back pain treatment a/e

a. pain management
b. exercise
c. remove the etiology
d. bed rest for 3 months

Ans: d h 17th 115

246. Athletes pubalgia is

a. abdominal muscle strain

b. rectus femoris strain
c. quadriceps strain
d. gluteus maximus strain

Ans: a.

247. high tibial osteotomy all true except

a. > 30 degree correction

b. though cancellous bone
c. high chance of recurrence
d.

Ans: a.

248. what is the most common cause of death after total hip replacement

a. infection
b. deep vein thrombus?
c. pulmonary embolism
d. pneumonia

Ans: c.

OG

249. vaginal delivery allowed in a/e

a. monochorionic monoamniotic twins

b. first twin cephalic and second breech
c. extended breech
d. mento anterior

ans. a. monochorionic monoamniotic twin

250. creamy and fishy odour vaginal discharge is seen in

a. trichomonas vag
b. candida albicans
c. gardnerella vaginalis
d. chlamydia trachomatis

ans: c. h 17th 827

251. Dysgerminoma marker

a. beta hcg
b. AFP
c. LDH
d.CA-A 19-9

ans. c. LDH

252. which is not primary amennorhoea

a. sheehans synd
b. kallmans synd
c. mayer rokitansky kuster hauser synd
d. turner syndrome

ans a. sheehans syndrome

253. contraceptive of choice in lactating female

a. barrier
b. lactational amenorrhoea
c. ocps
d. pop

ans A

Nonhormonal methods of contraception (barrier contraception, copper intrauterine device) are

preferred in nursing mothers because hormonal contraception may interfere with lactation and
transfer of hormones into milk poses a theoretical risk to the infant. Progestin only — If hormonal
methods are to be used, progestin-only contraceptives are the preferred method for breastfeeding
women

254. Lupus anticoagulant true

a. increase in aPTT only

b. recurrent 2nd trimester abortion in pregnant females
c. can occur without other symptoms of anti phospholipid antibody syndrome
d. thrombotic spells/ severe life threatening haemorrage?

Ans: b.

An international committee proposed the following criteria for defining adverse pregnancy outcomes
in the diagnosis of APS : Abortion is the delivery of a pregnancy, either spontaneously (miscarriage)
or electively, before 20 weeks of gestation. A first trimester abortion occurs up to 13 weeks of
gestation, a second trimester abortion occurs between 14 and 20 weeks.
255. para 3+0, 35yrs lady P3+0 cin3 . t/t

a. LEEP
b. hysterectomy
c. conization
d. cryotherapy

ans. a. LEEP ? ref. csdt and novazek

LEEP is rx of choice in CIN 2 n 3...... CGDT pg 840
c. shaw 385 h 608

256. mifepristone used in

a. threatened abortion
b. fibroid
c. ectopic pregnancy
d. molar pregnancy

Ans: a? shaw 345 c? page 287 14th shaws

257. 35 yr old F posted for laproscopic sterilisation a/e r CI for operation

a. obesity
b. heart disease
c. hb<8
d. hiatus hernia

Ans: a C/I in extreme obesity not obesity shaw 238

258. best non surgical treatment of stress incontinence

a. pelvic floor muscle training

b. bladder training
c. electrical stimulation
d.

Ans: a csdt 1072

259. the following drug can be given safe in pregnancy

a. propylthiouracil

Ans: a.

260. all drugs can be given to a mother with lupus who is on 35th week of gestation
except

a. chloroquine
b. methotrexate
c. sulphadiazine/ sulphasalazine?
d. prednisolone

Ans: b/c?

261. surgical staging of ovarian ca all done except

a. peritoneal washing
b. peritoneal biopsy
c. mesenteric biopsy
d. palpation of organs
Ans: b peritoneal biopsy h 17th 605

262. In which condition is the onset of condition to death the lowest

a. post partum hmge

b. antepartum hmge
c. obstructed labour
d. septicaemia

Ans: a.

263. DMPA benefits a/e

a..3% failure rate in 1st year

b. no increased endometrial carcinoma like OCP
c. can be used in seizures
d. can be given in sickle cell anaemia

ANS-A

The 1st year failure rate for DMPA was less than 1%, with a 3-year net cumulative failure rate of
only 2%

www.popline.org/docs/0655/028313.html

264. tamoxifen side effect a/e

a. thromboembolism
b. endometrial carcinoma
c. opposite side breast carcinoma
d. cataract

Ans: c kat 671

265. all r seen in eclampsia except

a. ARF
b. cerebral haemorrhage
c. pulmonary edema?
d. DVT

Ans: d? deep vein thrombosis dutta 234

266. evidence based treatment for mennorrhagia are a/e

a. ocp
b. etamsylate
c. tranexemic acid
d. progesterone 5 to 25 days cyclically

ANS-B

Evidence
Danazol and etamsylate (not recommended)

Danazol is a synthetic androgenic steroid with anti-oestrogenic and anti-progestogenic properties. It

inhibits proliferation of the endometrium:
The National Institute for Health and Clinical Excellence (NICE) identified two systematic reviews
and a subsequent primary study that showed danazol is an effective treatment in reducing blood
loss:
Danazol was found to reduce blood loss by about 50%.
Danazol was found to be more effective than nonsteroidal anti-inflammatory drugs (NSAIDs) or
progestogens. However, it also caused significantly more adverse effects than these drugs. Some of
these adverse effects are severe enough to warrant stopping treatment (mainly androgenic-related
adverse effects).
After analyzing the benefit–risk ratio and considering the availability of other treatments, NICE
concluded that danazol should not be recommended for the treatment of menorrhagia.
Etamsylate reduces capillary bleeding by correcting anomalies of platelet adhesion without unduly
affecting the fibrin cascade.

NICE identified three systematic reviews that

assessed the use of etamsylate. Together,
these found that:
Etamsylate reduced menstrual blood loss by an
average of 13%.
Etamsylate was not as effective as NSAIDs or
antifibrinolytic drugs.
NICE concluded that, given the other drug
treatments available, etamsylate was not
effective enough to be recommended.
www.cks.library.nhs.uk/menorrhagia/evidence/supporting_evidence/drugs...menorrhagia/danazol_a
nd_etamsylate_not_recom... -

267. all are effect of estrogen except

a. decreased HDL
b. increased triglycerides
c. increased LDL
d. increased apolipoprotein

Ans: a. kat 658

268. HRT a/e

a. it doesnt reduce the risk of osteoporosis in post menopausal women

b. CI in DM
c. dermal patch estrogen decreases the probability of thromboembolism than oral estrogen
d. pre menopausal women can be given upto 50 yrs of age.

Ans: a.

Peads

269. pregnant woman, cervical lymph node +ve, in 1st trimester is given spiramycin &
baby born with hydrocephalus. Infection was by

a. HSV
b. treponema pallidum
c. rubella
d. toxoplasmosis

ANS TOXOPLASMOSIS h 1308??rubella??

270. neonate response to acute hypoxia is

a. tachycardia
b. bradycardia
c. cardiac arrest
d. vent arrythmias

Ans: a

271. neuroblastoma all true except

a. most common extracranial solid tumour in children

b. >50% come with mets/ abd mass
c. lung metastsis common
d. involve aorta and branches at early stage

ANS-C

Metastatic involvement of the liver is common in infants,

and can cause respiratory compromise . Neuroblastomas
also may spread to lung and brain parenchyma, but this
usually occurs as a manifestation of relapsing or end-stage
disease
272. A 5yr old male with bp 130/80 with enlarged phallus height 104 cm and developed
pubic hair. levels of which will be diagnostic

a. 11 deoxy cortisol
b. deoxycorticosterone
c. 17 oh progesterone
d. aldosterone

Ans: b

273. child presents with progressive loss of developmental milestones, bites her fingers.
Presents with head banging and writhing movements of hands. Most probable diagnosis

a. hgprtase def
b. adenosine deaminase def
c. phenylalanine hydroxylase def
d.

Ans: a. har 308 (lesh nyhan synd)

274. A 9 yr old girl having bleeding with prolonged aPTT but normal PT, diagnosis

a. Haemophilia A
b. Haemophilia B
c. vonWillebrand's disease
d. Factor V mutation

Ans: c. h 723??

275. a down syndrome patient is posted for surgery, the necessary pre-op investigation
to be done is
a. echocardiography
b. ct brain
c. x ray cervical spine
d. USG abdomen

Ans: C

276. a female child was brought with complaint of generalised swelling of her body. She
was passing fatty cast in her urine. No haematuria. The true statement is

a. no IgG or C3 deposition seen on renal biopsy

b. her C3 levels could be low
c. IgA nephropathy is likely
d. alport syndrome

Ans: b?

277. childhood renal polycystic disease true a/e

a. autosomal dominant
b. renal and hepatic cysts
c.
d.

Ans: a h 17th 1796

278. limb defects with scarring of skin in new born

a. varicella virus
b. hsv
c. herpes simplex
d. syphilis

Ans: a. varicella

279. Wilm's Tumor prognostic staging

a. National Wilm tumor study group

b. AJCC
c. TNM
d. International Society of Pediatric Oncology

Ans: a? d

280. HepB infected neonate given

a. both Vaccine and Immunoglobulin

Ans: a

281. The most sensitive indicator of intravascular volume in the pediatric patient is

a. heart rate
b. preload
c. stroke volume
d. cardiac output

Ans: a.

282. a 6 year old girl comes with dyspnea and cough... after primary treatment she was
sent home.. a weak later the whole lung on right side was opacified on cxr... what's
probable diagnosis

a. foreign body aspiration

b. pneumonia
c. bronciolitis obliterance
d. pleural effusion

Ans: a. CSDT 1311

283. ventral neural tube defect marker is

a. phoshphatidyl esterase
b.
c. acetyl choline esterase
d.

Ans: c.

ENT

284. trotters triad have all except

a. deafness
b. palatal palsy
c. trigeminal neuralgia
d. seizures

ans : d. seizures

285. meningitis leads to vestibulitis through

a. hyrtle fissure
b. endolymphatic sac
c. cochlear aqueduct
d. vestibular aqueduct

Ans: c

286. Laryngeal pseudosulcus true is

a. due to vocal abuse

b. laryngeal reflux
c. tb
d.

Ans: ?

Opthal

287. true about juxta foveal telengiectasia a/e

a. variant of coats
b. macular telengiectasia
c. seen in diabetes mellitus
d. structural abnormality is seen in vessels

Ans: ?

288. Which of these is not done in advanced proliferative diabetic retinopathy

a. Removal of epiretinal membranes

b. Vitrectomy
c. Exo-photocoagulation
d. Reattachment of retina

Ans: a.? c. parson 20th 297?

289. uveal effusion seen in a/e

a. myopia
b. abnormal scleral structure
c. scleritis
d. cilio-choroid can get separated

Ans: ?

290. Carotid artery emboli and CRVO are differentiated by

a. Dilated veins
b. Tortuous veins
c. ophthalmodynamometry
d. arterial pressure

Ans: c

291. LDH increased in vitreous humor in

a. retinoblastoma
b. galactosemia
c. glaucoma
d.

Ans: a. khurana 4th 282

292. visual cycle true is

a. condensation of opsin with aldehyde of retinol

b. NADP is reduced
c. NAD is reduced
d. hydrolysis of visual purple/ combination of opsin with retinol to form visual purple?

Ans: a/d?

Anaesthesia

293. Successful paravertebral block given by anaesthetist can go to a/e

a. epidural space
b. subarachnoid space
c. paravertebral space
d. intercostals space

ans: b. subarachnoid space

294. Signs of successful Stellate block A/E

a. Unilateral Nasal stuffiness

b. Guttman sign
c. Miosis
d. Bradycardia

ans: d. Bradycardia

296. sodium bicarbonate added as adjuct to local Anaesthesia because

a. quick onset and longer action
b. delayed onset and longer action
c. shorter duation of action
d. for rapid removal

Ans: a katjung 10th 419

Radiology

295. Which test is performed to detect reversible myocardial ischemia

a. Coronary angiography
b. MUGA scan
c. Thallium scan
d. Resting ECHO

ans c.thallium scan ref: h 17th 1519

297. investigations of choice for DUCTAL CARCINOMA IN SITU

a.mammograpy
b.mri
c.pet
d.ultrasound

Ans: b?

298. Mammography less sensitive in young women because

a. less gland & more fat

b. more glandular and dense
c. uncooperative
d.

Ans: b.

299. adrenal adenoma shows a/e

a. hypoechoic on non contrast ct

b. contrast appears early and washes out late
c. regular border
d. microcalcification/ b/l glands enlarged?

ANS-D

Adrenocortical adenoma-general

2/3 women, usually ages 30-40 years

Detected incidentally at autopsy (usually nonfunctional), from unrelated radiographic studies, or due
to hyperfunction of zona glomerulosa (increased mineralocorticoids / Conn’s syndrome), zona
fasciculata (increased glucocorticoids / Cushing’s syndrome) or zona reticularis (increased sex
steroids / adrenogenital syndrome)

If nonfunctional, adjacent adrenal has normal

cortical thickness; if functional, adjacent
adrenal will be atrophic
May be ectopic (i.e. not located in adrenal gland)

Rarely mixed together with pheochromocytoma or myelolipoma

Diagnose as “adrenocortical neoplasm” and estimate risk of recurrent or metastatic tumor if cannot
differentiate between adenoma and carcinoma

Somewhat common site for lung metastases, for unknown reasons (Archives 1988;112:286)

Treatment: excision

http://www.pathologyoutlines.com/adrenal.html

300. pulmonary artery pruning seen in

a. pulmonary HT
b. pulmonary edema
c.
d.

Ans: a h 1576

301. child fell down and became unconscious. Breathing and ventilation checked. Next
step is

a. check the pulse

b. give cpr
c. secure proper airway

Ans: a?

302.anterior perforating substance is related to

a. LIMEN INSULAE
b. uncus

ANS-A